OBJECTIVES: To perform comparative pharmacoeconomic analysis of application of tocilizumab and adalimumab in adult patient with active rheumatoid arthritis and intolerance and/or futility of further therapy with basic anti-inflammatory drugs.   METHODS: A pharmacoeconomic model was created basing on the data of ADACTA clinical trial, which included monotherapy with tocilizumab and adalimumab in a target population of patients (two groups, 100 patients each). Direct financial costs of drug therapy and cost efficiency of competing medical technologies were determined. Measures of efficiency were the reduction of DAS28 disease activity index compared to the initiate level; share of patients with remission of low disease activity according to DAS28 index; share of patients that responded to the therapy according to ACR20/ACR50/АCR70 criteria on week 24. RESULTS: Costs of drug therapy per patient were 582,611.52 RUB for tocilizumab, and 493,680.00 RUB for adalimumab. Cost-effectiveness in the reduction of disease activity according to DAS28 index were 176,548.94 in tocilizumab group, and 274,266.67 in adalimumab group. CER with regard to the share of patients with remission were 1,460,179.24 and 4,701,714.29 for tocilizumab and adalimumab, respectively. Cost-effectiveness of the achievement of low activity of rheumatoid arthritis according to DAS28 index also was more favorable in case of tocilizumab (1 131,284.50 and 2,493,333.33). Therefore, cost-effectiveness was always more favorable in the group of tocilizumab.  CONCLUSIONS: Administration of tocilizumab in adult patients with active rheumatoid arthritis and intolerance and/or futility of further therapy with basic anti-inflammatory drugs was 3 times more cost-effectiveness compared to adalimumab  (the ratio may change depending on the efficiency value).